Apparatus and method of an osteotomy for dental implant

ABSTRACT

The present disclosure relates to a method of manufacture of a dental implant for a molar, including acquiring, structural data corresponding to bones of the facial skeleton, the bones of the facial skeleton being proximate the molar, selecting, as a dental implant fixation surface, a surface of the bones based upon a determined thickness of the bones, generating, based on the selected dental implant fixation surface, a contoured surface of the dental implant, and fabricating, based upon an instruction transmitted by processing circuitry, a bone plate extending from a buccal end of a cylindrical plate of the dental implant, the cylindrical plate having support lattices extending therefrom, at least one support lattice of the support lattices being arranged on a lingual end of the cylindrical plate, the cylindrical plate having an opening in a central region thereof, the opening being configured to receive a dental post.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application claims priority to U.S. Provisional ApplicationNo. 63/126,428, filed Dec. 16, 2020, the entire contents of which isincorporated by reference herein in its entirety for all purposes.

BACKGROUND Field of the Disclosure

The present disclosure relates to an apparatus and a method of anosteotomy for dental implant.

Description of the Related Art

Conventional dental implant technologies benefit from a lack ofcompetition posed by from alternative technologies. However, the marketof dental implants has been waning under pressure from value branddental implants sold online because conventional dental implants have asimilar reasonable level of success but they also have the same limitedcapabilities, e.g., need for adequate alveolar bone even the lowestlevel of success.

The foregoing “Background” description is for the purpose of generallypresenting the context of the disclosure. Work of the inventors, to theextent it is described in this background section, as well as aspects ofthe description which may not otherwise qualify as prior art at the timeof filing, are neither expressly or impliedly admitted as prior artagainst the present disclosure.

Aspects of the invention may address some of the above-describedshortcomings in the art, particularly using solutions set forth in theclaims.

SUMMARY

The present disclosure relates to apparatus and method for a verticalosteotomy for dental implant.

The present disclosure includes a method of manufacture of a dentalimplant for a molar, including acquiring, by processing circuitry,structural data corresponding to one or more bones of the facialskeleton, the one or more bones of the facial skeleton being proximatethe molar; selecting, by the processing circuitry and as a dentalimplant fixation surface, a surface of the one or more bones of thefacial skeleton based upon a determined thickness of the one or morebones of the facial skeleton; generating, by the processing circuitryand based on the selected dental implant fixation surface, a contouredsurface of the dental implant; and fabricating, based upon aninstruction transmitted by the processing circuitry, a bone plateextending from a buccal end of a cylindrical plate of the dentalimplant, the cylindrical plate having support lattices extendingtherefrom, at least one support lattice of the support lattices beingarranged on a lingual end of the cylindrical plate, the cylindricalplate having an opening in a central region thereof, the opening beingconfigured to receive a dental post.

The present disclosure includes a dental implant for a molar, includinga dental post; a cylindrical plate having an opening in a central regionthereof, the opening being configured to receive the dental post; a boneplate extending from a buccal end of the cylindrical plate, the boneplate having a surface for contact with one or more bones of the facialskeleton, the surface being contoured relative to a surface of the oneor more bones of the facial skeleton and based on a thickness of the oneor more bones of the facial skeleton; and support lattices coupled tothe cylindrical plate, the support lattices extending from a lingual endthe cylindrical plate, the support lattices including an aperture forfixation.

The foregoing paragraphs have been provided by way of generalintroduction, and are not intended to limit the scope of the followingclaims. The described features, together with further advantages, willbe best understood by reference to the following detailed descriptiontaken in conjunction with the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

A more complete appreciation of the disclosure and many of the attendantadvantages thereof will be readily obtained as the same becomes betterunderstood by reference to the following detailed description whenconsidered in connection with the accompanying drawings, wherein:

FIG. 1A is a schematic of a dental implant system, within the scope ofthe present disclosure;

FIG. 1B is a radiograph of a dental implant system in vivo, within thescope of the present disclosure;

FIG. 2A provides a view of an exemplary custom 3D printed upper molar(UM) transalveolar dental implant for immediate restoration of anatomyand function after extraction, within the scope of the presentdisclosure;

FIG. 2B provides a view of an exemplary custom 3D printed UMtransalveolar dental implant for immediate restoration of anatomy andfunction after extraction, within the scope of the present disclosure;

FIG. 2C provides a view of an exemplary custom 3D printed UMtransalveolar dental implant for immediate restoration of anatomy andfunction after extraction, within the scope of the present disclosure;

FIG. 2D provides a view of an exemplary custom 3D printed UMtransalveolar dental implant for immediate restoration of anatomy andfunction after extraction, within the scope of the present disclosure;

FIG. 2E provides a view of an exemplary custom 3D printed UMtransalveolar dental implant for immediate restoration of anatomy andfunction after extraction, within the scope of the present disclosure;

FIG. 2F provides a view of an exemplary custom 3D printed UMtransalveolar dental implant for immediate restoration of anatomy andfunction after extraction, within the scope of the present disclosure;

FIG. 3 is a cross-sectional schematic of a transalveolar dental implant,within the scope of the present disclosure;

FIG. 4A is a schematic of an anterior view of a transalveolar dentalimplant, within the scope of the present disclosure;

FIG. 4B is a schematic of a lateral view of a transalveolar dentalimplant, within the scope of the present disclosure;

FIG. 5A is a schematic of an anterior view of a transalveolar dentalimplant, within the scope of the present disclosure;

FIG. 5B is a schematic of a lateral view of a transalveolar dentalimplant, within the scope of the present disclosure;

FIG. 5C is a perspective view of a transalveolar dental implant, withinthe scope of the present disclosure;

FIG. 6 is a flowchart of fabrication of a transalveolar dental implant,within the scope of the present disclosure.

FIG. 7A provides a view of a dental post secured to the lower molar (LM)transalveolar dental implant plate, within the scope of the presentdisclosure;

FIG. 7B provides a view of a dental post secured to the LM transalveolardental implant plate, within the scope of the present disclosure;

FIG. 7C is an exemplary 3D printed LM transalveolar dental implant,within the scope of the present disclosure;

FIG. 7D is a flow diagram of a process of an analog crown over graft,within the scope of the present disclosure;

FIG. 8A is an exemplary failed conventional dental implants, within thescope of the present disclosure;

FIG. 8B is a cross sectional view of mandibular body posterior to mentalforamina with sublingual transalveolar dental implant (SL-TDI), withinthe scope of the present disclosure;

FIG. 8C is a cross sectional view of mandibular body posterior to mentalforamina with SL-TDI, within the scope of the present disclosure;

FIG. 9A is an exemplary bilateral SL-TDI for immediate full archmandibular reconstruction, within the scope of the present disclosure;

FIG. 9B is a cross section view of the exemplary bilateral SL-TDI,within the scope of the present disclosure;

FIG. 10 is an illustration of one or more implanted transvestibulardental implants, within the scope of the present disclosure;

FIG. 11 is a lateral sinus wall with a template showing outline ofosteotomy in three views, within the scope of the present disclosure;

FIG. 12A provides a view of cutting channel guide mounted on masterindex template and burr with disk bushing to insert into channel forvertical osteotomies, within the scope of the present disclosure;

FIG. 12B provides a view of cutting channel guide mounted on masterindex template and burr with disk bushing to insert into channel forvertical osteotomies, within the scope of the present disclosure;

FIG. 12C provides a view of cutting channel guide mounted on masterindex template and burr with disk bushing to insert into channel forvertical osteotomies, within the scope of the present disclosure;

FIG. 12D-1 to FIG. 12M-1 show a sequence of stents used to preciselyexcise the alveolar bone using a resection template, within the scope ofthe present disclosure.

FIG. 12D-2 to 12M-2 is the occlusal view of the same templates andsequence of steps, within the scope of the present disclosure.

FIG. 12N-1 and FIG. 12N-2 show views of the fasteners used tointerchange the templates, within the scope of the present disclosure.

FIG. 13 is a flow diagram of a preoperative procedure, within the scopeof the present disclosure; and

FIG. 14 is a hardware description of a data processing device, withinthe scope of the present disclosure.

DETAILED DESCRIPTION

The terms “a” or “an”, as used herein, are defined as one or more thanone. The term “plurality”, as used herein, is defined as two or morethan two. The term “another”, as used herein, is defined as at least asecond or more. The terms “including” and/or “having”, as used herein,are defined as comprising (e.g., open language). Reference throughoutthis document to “one embodiment”, “certain embodiments”, “anembodiment”, “an implementation”, “an example” or similar terms meansthat a particular feature, structure, or characteristic described inconnection with the embodiment is included in at least one embodiment ofthe present disclosure. Thus, the appearances of such phrases or invarious places throughout this specification are not necessarily allreferring to the same embodiment. Furthermore, the particular features,structures, or characteristics may be combined in any suitable manner inone or more embodiments without limitation.

Unless indicated otherwise, the features and embodiments describedherein are operable together in any permutation.

The terms “about” and “approximately” are defined as being close to asunderstood by one of ordinary skill in the art.

The process of the present disclosure can “comprise,” “consistessentially of,” or “consist of” particular ingredients, components,compositions, etc., disclosed throughout the specification.

The present disclosure describes transalveolar dental implant (TDI)directed to upper molars and lower molars of a patient's dentition. Suchupper molar TDI (UM-TDI) and lower molar (LM-TDI) provide apatient-specific, custom manufactured, and uniquely applied dentalimplant system. Such as a system is not merely an improvement or anaddition to the current dental implant parts bin. LM-TDI and UM-TDI useadvanced digital systems to image, analyze, design and 3D print customtitanium dental implant devices, acrylic surgical templates, and acrylictemporary prostheses to provide predictable, one stage surgery for theimmediate restoration of form and function of removed teeth.

The present disclosure, LM-TDI and UM-TDI, may allow surgeons to removea tooth, multiple teeth, or an entire dental arch and replace thedentition on root form implants embedded accurately within the residualalveolus and secured to adjacent cortical bone by attached customcontoured bone plates and screws for immediate restoration of dentalanatomy and function.

Conventional dental implants have been unable to address many importantclinical situations as interest in dental implants shifts from dentures,which traditionally have dominated the dental implant market, torestoration of individual teeth for patients who otherwise have healthydentition.

The LM-TDI and the UM-TDI of the present disclosure provide numerousadvantages, including immediate implant reconstruction after removal ofdentition versus staged procedures, immediate fixed prosthetic functionversus treatment phases of removable temporaries, highly accurate dentalpost and crown/prosthesis placement versus time-consuming chairsidecraftsmanship, and preservation of the alveolar contours and investingsoft tissue gingivae versus incomplete dental anatomy restoration.

In an embodiment, preserving the alveolus and gingivae is critical,particularly as it relates to anterior teeth, to maintain the smileaesthetics of gingival papillae filling dental embrasures. Preservationof gingivae is also important for posterior teeth to prevent food,debris, and plaque from accumulating in the embrasures. Only throughimmediate implant reconstruction with fixed dental crown analogs tosupport the alveolus and gingivae after surgery is treatment predictableto ensure complete dental anatomy restoration.

Beyond replacement of failed dentition, there is a significant medicalmarket to address the needs of patients with congenital anodontia, apatient population which includes ectodermal dysplasia, alveolar clefts,and other syndromes. These patients are treated in major medical centersby, for example, cleft palate teams, and their care is generouslysupported by government funding and private foundations. The coincidenceof these conditions, and thus the market thereof, is in the range of100,000 patients per year in the U.S. and much more when congenitalagenesis of maxillary lateral incisors is considered. These patients area special challenge because agenesis of a tooth is also agenesis ofalveolar bone.

With reference now to the Figures, and as background to the presentdisclosure, root-form dental implants are an effective strategy fordental reconstruction when sufficient alveolar bone is present. Comparedwith tooth-supported dental bridges, root-form dental implants, fixedwithin the alveolar bone, are able to maintain the health of theunderlying bone by preserving bone loading. FIG. 1A, for instance, showsa root-form dental implant comprised, initially, of a post 105, orscrew-like metal component, fixed within the alveolar bone of the facialskeleton. An abutment 110, which serves as a platform for a crown 150 tobe added later, is mechanically coupled to a base of the post 106.

In a radiograph, as seen in FIG. 1B, the post 105 is rigidly fixedwithin the alveolar bone, similar to the arrangement of a root 120 of anative tooth 121. In the majority of cases, patients go home with afunctional replacement, receive a permanent crown set when the implantis integrated (8-12 weeks), and are able to return to normal functionwith improved mastication, speech, and aesthetics.

In cases of inadequate bone, however, as a result of bone atrophy orskeletal pre-disposition, root-form dental implants, as described above,are not a surgical option. In such cases, it may be necessary to resortto special techniques including but not limited to bone grafts directedto bone atrophy, alveolar bone distraction osteogenesis, lifting of themaxillary sinus with bone filling, lateralization of the mandibular bonenerve, corticotomy, and alveolar expansion, with or without graft. Whilethe above approaches offer hope to certain patients, each carries withit a respective set of drawbacks. Generally, these techniques increasechair time and the number of associated laboratory steps required to fita dental prosthesis. Specifically, as in the case of bone grafting,risks of donor site morbidity and a time-intensive recovery period priorto implantation of dental implant hardware present significantchallenges to successful outcomes.

The present disclosure addresses the above-described drawbacks ofconventional approaches as they relate to the full range of dentition.

With reference now to FIG. 2A through FIG. 2F, different views of anexemplary custom 3D printed upper first molar TDI (UM-TDI) for immediaterestoration of anatomy and function after extraction are shown, withinthe scope of the present disclosure. In an embodiment, and as it relatesto a particular structure of the UM-TDI, FIG. 2A through FIG. 2F mayshare similar structural, material, and design characteristics with FIG.7A and FIG. 7B, which will be described later in greater details.

FIG. 2A shows individual structures of the dental implant including abone plate 205, a cylindrical plate 211, a dental post 212, and miniscrews 208, 210. The mini screws 208, 210 may be used to fix the supportlattices to the facial skeleton through an aperture 705, which will bedescribed later with respect to FIG. 7A and FIG. 7B.

In an embodiment, the dental post 212 may include a post base 201A, apost body 201B, and a post abutment platform 201C. The dental post 212which will be described in greater detail with reference to the dentalpost of FIG. 7A. The post body 201B may be the body portion of thedental post 212. The post base 201A may be coupled to an aspect of thebone plate 205. The dental post 212 may be configured to receive anabutment by features on the post abutment platform 201C.

In an embodiment, the dental post 212 can be a non-metallic materialsuch as zirconia, ceramic, fiber-reinforced resins, and carbon fiber,fiberglass, or a metallic material such as titanium, stainless steel,titanium alloy, and gold alloy. Other materials, as appropriate, mayalso be used.

In an embodiment, the bone plate 205 may comprise two portions, whichwill be described in further detail with reference to FIG. 3. A firstportion 242 may be a planar portion 242. A second portion 244 may be acontoured portion 244. The contoured portion 244 may be contoured withrespect to a selected region of the facial skeleton determined to be ofsufficient bone quality for fixation.

In an embodiment, the bone plate 205 may be fabricated via direct metallaser sintering. In an embodiment, the bone plate 205 can be anon-metallic material such as zirconia, ceramic, fiber-reinforcedresins, and carbon fiber, fiberglass, or a metallic material such astitanium, stainless steel, titanium alloy, and gold alloy. Othermaterials, as appropriate, may also be used.

In an embodiment, a thickness of the planar portion 242 of the boneplate 205 may be between 1 mm and 2 mm and a length of the planarportion 242 of the bone plate 205 may be between 6 mm and 10 mm. In anexample, the thickness of the planar portion 242 of the bone plate 205may be 1.5 mm and a length of the planar portion 242 of the bone plate205 may be 8 mm.

In an embodiment, and as described later in FIG. 3, a plurality ofthrough apertures 318 having locking threads and sized in accordancewith appropriate screws may be disposed along the length of thecontoured portion 244 of the bone plate 205, passing from an anteriorsurface to a posterior surface. The appropriate screws may be the miniscrews 208 of FIG. 2A through FIG. 2D.

In an embodiment, the quality of bone required for fixation of thecontoured portion 244 of the bone plate 205 is related, in part, to theselected screws 208, 210 for fixation and relative to a pre-determinedminimum cortical bone thickness. In an example, the pre-determinedminimum facial bone thickness is 1.5 mm. In another example, thepre-determined minimum facial bone thickness is based upon properties ofthe selected screw, including but not limited to diameter, pitch, andscrew length.

According to an embodiment, a width of the bone plate 205 can be equalto the diameter of the dental post 212. The thickness of the bone plate205 is determined according to the length of the bone plate 205, whereina longer bone plate 205 requires an increase in thickness of the boneplate 205 to support the dental post 212 and prevent excessmicro-motion. In an example, the thickness of the bone plate 205 rangesbetween 1.00 mm and 3.00 mm, and preferably between 1.25 mm and 2.00 mm.The length of the bone plate 205, therefore, is determined according tolocally sufficient cortical bone.

In an embodiment, the cylindrical plate 211 may be, but is not limitedto, a plate with a cylindrical shape or a pillar with an opening in thecenter portion, which will be described in more detail with reference toFIG. 7A. The dental post 212 may be rotationally coupled to the openingin the cylindrical plate 211. The opening of the cylindrical plate maybe threaded. The diameter of the opening of cylindrical plate 211 may bebetween 3 mm and 5 mm. The diameter of the opening may be compatiblewith the diameter of the post apex (not shown in FIG. 2A through FIG.2F) of the dental post 212.

In an embodiment, the cylindrical plate 211 can be a non-metallicmaterial such as zirconia, ceramic, fiber-reinforced resins, and carbonfiber, fiberglass, or a metallic material such as titanium, stainlesssteel, titanium alloy, and gold alloy. Other materials, as appropriate,may also be used. The outer diameter of the cylindrical plate 211 may bebetween 4 mm and 6 mm.

In an embodiment, the mini screws 208, 210 may be used to fix the boneplate 205 to the facial skeleton. The mini screws 208, 210 can be, butis not limited to, a metallic material such as titanium, stainlesssteel, titanium alloy, and gold alloy. Other materials, as appropriate,may also be used. The length of the mini screws 208, 201 may bedependent on the thickness of the cortical bone. For example, the lengthof mini screws 208, 210 may be between 5 mm and 6 mm if the thickness ofthe cortical bone is 2 mm.

FIG. 2B is an illustration of a front view of the UM-TDI plate securedto the zygoma and alveolar cortices with mini screws on tooth 214 (#3).FIG. 2C and FIG. 2D are an illustration of a bilateral implementation ofthe UM-TDI of the present disclosure. FIG. 2C illustrates a front viewof the bilateral UM-TDI and FIG. 2D illustrates a rear view of thebi-lateral UM-TDI, wherein respective bone plates may be secured to thezygoma and alveolar cortices by mini screws on tooth 214 (#3) and tooth216 (#14).

In an embodiment, the UM-TDI device 200 has a contoured bone plate 205configured to be in contact with zygomatic bone 202 of the facialskeleton, the bone plate 205 being designed in order to pass through asmall buccal osteotomy (e.g., pass-through osteotomy 204) and extendsuperiorly to the thick cortex of the zygomatic buttress. Fixing thebone plate 205 to the zygomatic bone 202 is essential when, as isparticular to the upper molar, buccal roots of the tooth reduce thevolume of cortical bone that can be used for fixation. On the palatalside, e.g., palate 206, of the alveolus, two small plate extensions ofthe UM-TDI device 200 are configured to rest on prepared inner aspectsof the alveolar cortex. Once the UM-TDI device 200 is engaged with thezygomatic buttress of the zygoma bone 202 and the inner alveolar palatalcortex (e.g., palate 206), the UM-TDI 200 can be secured by mini screws208, 210. A dental post 212 can then be secured to the base of thedevice via frictional coupling (e.g., locking screw technology). In anembodiment, the dental post 212 can be a non-metallic material such aszirconia, ceramic, fiber-reinforced resins, and carbon fiber,fiberglass, or a metallic material such as titanium, stainless steel,titanium alloy, and gold alloy. Other materials, as appropriate, mayalso be used. The alveolus with the embedded UM-TDI device 200 is thenbone grafted and a naturally contoured crown analog is secured to thedental post 212 to cover the graft and support the investing gingivalcontours for complete restoration of the dental anatomy and function.The dental posts may be connected to tooth 214 (#3) and 216 (#14).

In an embodiment, the bone plate 205 extends from a buccal end of thecylindrical plate 211. The bone plate 205 may have a surface for contactwith bones of the facial skeleton such as the zygoma bone 202. Thesurface of the bone plate 205 may be contoured relative to a surface ofthe bones of the facial skeleton such as the zygoma bone 202 and may bebased on a thickness of the bones of the facial skeleton.

In some embodiments, the UM-TDI device 200 may be used for both uppermolars.

FIG. 2E and FIG. 2F show side views of the UM-TDI plates on tooth 214(#3) and tooth 216 (#14). As described earlier, the side views of theUM-TDI plates may show the bone plate 205, the dental post 212, miniscrews 208, 210, and zygoma bone 202.

In an embodiment, the mini screws 208 may be in the center portion ofthe bone plate 205. As mentioned earlier, the mini screws 208, 210 maybe used to fix the support lattices to the facial skeleton through anaperture 705, which will be described later with respect to FIG. 7A andFIG. 7B. The number of the apertures 705 may be dependent on theselected skeletal region and the minimum number of screws required inorder to secure the bone plate 205 to the facial skeleton.

In an embodiment, the length of the UM-TDI plates may be between 16 mmand 30 mm. The length of the UM-TDI may be dependent on the thickness ofthe cortical bone. For example, the length of the UM-TDI plates may be20 mm if the thickness of the cortical bone is 2.5 mm.

In another embodiment, as alluded to above, a length of the dental post212 may be between 6 mm and 10 mm. In an example, the length of thedental post 212 may be 8 mm.

The UM-TDI of FIG. 2A through FIG. 2F may be based on a transalveolardental implant (TDI), as described in FIG. 3 through FIG. 6. Forinstance, the bone plate 205 of the UM-TDI of FIG. 2A through FIG. 2Fmay be similar to the bone plate of the TDI of FIG. 3 through FIG. 6.

In an embodiment, the TDI includes a contoured bone plate extendingtransalveolarly through an alveolar bone vertical slot osteotomy to anadjacent bone of the facial skeleton, thus providing primary stabilityto the TDI. The alveolar bone vertical slot osteotomy, with newlyresident post, is filled via bone grafting to ensure bone regenerationand stabilization of the post. In an example, where four TDIs areimplanted around the dental arch, a full dental arch prosthesis may becoupled to the TDIs for immediate function.

FIG. 3 describes an exemplary embodiment of a TDI, which may beimplemented in the present disclosure as a component of the UM-TDIand/or a LM-TDI, which will be described later.

In an embodiment, the TDI 301 is directed to a region of the facialskeleton known as the alveolar bone, a thickened bony region thatsupports the dental root system. The TDI 301 of the present disclosureincludes a post 305. The post 305 includes a post base 307 and a postapex 306. The post base 307 may be designed to receive an abutment. Thepost apex 306, instead of being coupled to trabeculae of the alveolarapex, may be coupled to an aspect of the bone plate 315. The bone plate315 may comprise two portions. The first portion may be a planar portion317 meant for coupling with the post apex 306 and for physicalinteraction with a captive surface of an osteotomy, the captive surfacebeing, in an upper arch embodiment of the present disclosure, a superiorportion of the osteotomy. The second portion may be a contoured portion316. The contoured portion 316 may be contoured with respect to aselected region of the facial skeleton determined to be of sufficientbone quality for fixation.

In an embodiment, an axis of the contoured portion 316 may be related toa longitudinal axis 311 of the bone plate 315 by an anterior angle 313.A plurality of through apertures 318 having locking threads and sized inaccordance with appropriate screws are disposed along the length of thecontoured portion 316 of the bone plate 315, passing from an anteriorsurface 302 to a posterior surface 303, for fixation of the TDI 301, viathe posterior surface 303, to the facial skeleton.

In another embodiment, the plurality of through apertures 318, lackingthreads and sized in accordance with appropriate screws, may be disposedalong the length of the contoured portion 316 of the bone plate 315,passing from the anterior surface 302 to the posterior surface 303, forfixation of the TDI 301, via the poster surface 303, to the facialskeleton.

The quality of bone required for fixation of the contoured portion 316of the bone plate 315 is related, in part, to the selected screws forfixation and relative to a pre-determined minimum cortical bonethickness. In an example, the pre-determined minimum cortical bonethickness is 1.5 mm. In another example, the pre-determined minimumcortical bone thickness is based upon properties of the selected screw,including but not limited to diameter, pitch, and screw length.

As briefly described, the contoured portion 316 of the TDI 301 isdesigned in the context of an individual patient's skeletal structure.Following the acquisition and reconstruction of medical images, via adata processing device having a processing circuitry, reflecting themacro- and micro-structure of the bone of the facial skeleton, viatechniques including but not limited micro-computed tomography, conebeam computed tomography, and high-resolution magnetic resolutionimaging, one or more regions of the facial skeleton are selected asreceptive to fixation of a bone plate. According to an embodiment, andas mentioned above, this determination is made based upon local corticalbone thickness, wherein sufficient cortical bone, the dense outersurface of bone, is required to prevent fracture during bone platefixation. Following region selection, a reconstructed model of the oneor more regions of interest is then further manipulated via software(e.g. Mimics, SolidWorks) and prepared for manufacturing, as would beunderstood by one of ordinary skill in the art.

According to an embodiment, the posterior surface 303 of the bone plate315 is contoured relative to the selected facial skeleton region and theanterior surface 302 of the bone plate 315 is substantially planar. Itshould be appreciated that the anterior surface 302 of the bone plate315 may be of a variety of contours, in a nonlimiting manner, such thatrigid fixation, via screws through the plurality of through apertures318, may be realized.

Each bone plate 315 is manufactured in order to allow rigid fixation tothe facial skeleton of the patient and to promote osseointegrationbetween the TDI 301 and the periprosthetic bone. To this end, andaccording to an embodiment, the TDI 301 of the present disclosure can bemanufactured from one of a group of materials including but not limitedto titanium, cobalt-chrome, cobalt-chrome-molybdenum,cobalt-chrome-nickel, cobalt-nickel-chrome-molybdenum-titanium, calciumphosphate-derivative coated metals, zirconia, zirconium-coated metals,titanium-coated metals, and other biocompatible metals. In an example,the material selected for each component of the TDI 301 is similar.Further, and according to an embodiment, the TDI 301 of the presentdisclosure can be manufactured via a variety of additive manufacturingor subtractive manufacturing techniques including but not limited todirect metal laser sintering, injection molding, iterative plate bendingand computer-aided manufacturing.

In another embodiment, the bone plate 315 and the post 305 aremanufactured separately, the bone plate 315 being fabricated accordingto the above-described techniques and the post 305 being manufacturedaccording to techniques understood by one of ordinary skill in the art.In another embodiment, the bone plate 315 and the post 305 aremanufactured together via three-dimensional metal printing. Followingfabrication, the two components of the TDI 301 can be coupled at ajunction consisting of the planar portion 317 of the bone plate 315 andthe post apex 306 of the post 305. The coupling can be formed by avariety of approaches including but not limited to welding, frictionalcoupling, and structural adhesives. In the context of the presentdisclosure, screws are selected for the plurality of through apertures318, or may be fabricated according to pre-determined specifications, inorder to ensure rigid fixation of the bone plate 315 to the facialskeleton.

Further, and according to an embodiment, the TDI 301 of the presentdisclosure is manufactured according to physical dimensions of theselected skeletal features of each patient. As described above, thecontoured portion 316 of the bone plate 315 is manufactured according tothe selected skeletal region of each patient, the dimensions of thecontoured portion 316 dependent, thereof. The number of throughapertures 318, likewise, is dependent on the selected skeletal regionand the minimum number of screws required in order to secure the boneplate 315 to the facial skeleton.

In an embodiment, the post 305 and the planar portion 317 of the boneplate 315 can be selected from a group of pre-determined sizes, theirdimensions determined therein. In another embodiment, the post 316 andthe planar portion 317 of the bone plate 315 may be custom manufacturedaccording to the needs of the patient, the dimensions of the planarportion 317 of the bone plate 315 and post 316 being dependent, thereof.It should be appreciated that, using the above-described techniques andapproaches, the present disclosure affords the flexibility to fabricatethe TDI 301 with necessary dimensions based upon the needs of theindividual patient.

According to an embodiment, a width of the bone plate 315 is equal tothe diameter of the post 305. The thickness of the bone plate 315 isdetermined according to the length of the bone plate 315, wherein alonger bone plate 315 requires an increase in thickness of the boneplate 315 to support the post 305 and prevent excess micromotion. In anexample, the thickness of the bone plate 315 ranges between 1.00 mm and3.00 mm, and preferably between 1.25 mm and 2.00 mm. The length of thebone plate 315, therefore, is determined according to locally sufficientcortical bone.

According to an embodiment, the relative position of the post 305 andthe contoured portion 316 of the bone plate 315 along a bone plate axis,defined as an axis including the longitudinal axis 311 of the bone plate315, should be such that sufficient mechanical structure is provided tothe TDI to withstand vertical loading. In an example, the anterior angle313 between the post 305 and the contoured portion 316 of the bone plate315 along the plate axis ranges between 90 degrees and 180 degrees, andpreferably between 135 degrees and 180 degrees°.

According to an embodiment, and in accordance with United States Foodand Drug Administration Class 2 Special Controls Guidance on Root-formEndosseous Dental Implants and Endosseous Dental Abutments, the diameterof the post 205 may be no smaller than 3.25 mm, the length of the postno smaller than 7.00 mm, and the abutment offset by no more than 30degrees from a longitudinal axis of the post.

FIG. 4A and FIG. 4B provide additional illustrations of the TDI. In anembodiment, the bone plate of the UM-TDI and/or the LM-TDI may have astructure similar to that of the bone plate of the TDI. As shown in FIG.4A, an anterior view, the TDI may comprise a bone plate 415 having acontoured portion 416, specific to selected skeletal features, and apost 405. As shown in FIG. 4B, a lateral view, the TDI may furthercomprise a plurality of screws 412 configured according to a dimensionof a corresponding plurality of through apertures.

In an embodiment, a thickness of the planar portion of the bone plate422 may be between 1.00 mm and 2.00 mm and a length of the planarportion of the bone plate 423 may be between 3.00 mm and 5.00 mm. In anexample, the thickness of the planar portion of the bone plate 422 maybe 2.00 mm and a length of the planar portion of the bone plate 423 maybe 4.00 mm.

In another embodiment, as alluded to above, a length of a post 408 maybe between 7.00 mm and 12.00 mm. In an example, the length of the post408 may be 8.00 mm. Moreover, the contoured portion 416 of the boneplate 415 may be angled with respect to the post 405.

FIG. 5A, FIG. 5B, and FIG. 5C are illustrations of a variety of angularconfigurations of the contoured portion of the bone plate of the TDI. Asabove, it can be appreciated that the bone plate of the UM-TDI and/orthe LM-TDI may have a similar structure and/or arrangement to that ofthe bone plate of the TDI.

In an embodiment, as shown in FIG. 5A, a lateral angle 514 of acontoured portion 516 of a bone plate 515 may be between −60° and +60°relative to a longitudinal axis 511 of the bone plate 515, in a firstplane. In another embodiment, the lateral angle 514 of the contouredportion 516 of the bone plate 515 may be between −45° and +45°. In anexample, the lateral angle 514 of the contoured portion 516 of the boneplate 515 may be +25°.

In another embodiment, as shown in FIG. 5B, an anterior angle 513 of thecontoured portion 516 of the bone plate 515 may be between −60° and +60°relative to the longitudinal axis 511 of the bone plate 515, in a secondplane.

In another embodiment, the anterior angle 513 of the contoured portion516 of the bone plate 515 may be between −45° and +45°. In an example,the anterior angle 513 of the contoured portion 516 of the bone plate515 may be +15°.

FIG. 5C is a schematic of a perspective view of the TDI of the presentdisclosure, wherein a range of positions of the contoured portion 516 ofthe bone plate 515 may be visualized. In an embodiment, a variety ofanterior angles 513 and lateral angles 514 may be concurrently realized.

According to an embodiment, the above described ranges of anteriorangles 513 and lateral angles 514 are determined such that the boneplate 515 may withstand normal loading forces during movement of themouth including mastication, wherein anterior angles 513 and lateralangles 514 approximating 0° (or 180° in a different orientation) areideal for load transfer.

Manufacture of the TDI, LM-TDI, or UM-TDI, according to an exemplaryembodiment, is described in the flowchart of FIG. 6.

First, a cone beam computed tomography (CBCT or C-arm CT) of the facialskeleton (e.g., maxilla, mandible) is performed S630. The CBCT is aidedby the use of radiopaque stents that provide a preview of a finalrestoration relative to adjacent structures, allowing for informedsurgical planning. The radiopaque stent(s) also position the jaws intocentric relation with proper vertical dimension of occlusion.

In some embodiments, a CBCT image of the bones of the facial skeletonsproximate an upper molar for UM-TDI or a lower molar for LM-TDI may beacquired at the step S630. Radiopaque stents may also be used to providean informed surgical planning for UM-TDI or LM-TDI.

Next, virtual surgical planning, performed via the data processingdevice, locates TDI, LM-TDI, or UM-TDI, positions S631 with alignment ofa custom contoured bone plate along sufficiently thick cortical bones ofthe adjacent facial skeleton. According to an embodiment, the adjacentfacial skeleton includes but is not limited to the nasomaxillary pillarsand the zygomatic buttresses.

In some embodiments, the virtual surgical planning, performed via thedata processing device, may include a selection of a surface of thebones of the facial skeleton based upon a determined thickness of thebones of the facial skeleton for the UM-TDI and LM-TDI in the step S630.

Following selection of the regions of interest, and after incorporatingthree-dimensional anatomical data into software S633, via the dataprocessing device, the planar portion and contoured portion of the boneplate may be manufactured S632 according to the above-described methods.In an example, the bone plate is manufactured via additive titaniumlaser sintering to promote osseointegration.

In some embodiments, the data processing device may generate a contouredsurface of the dental implant based on the selected dental implantfixation surface for the UM-TDI and LM-TDI.

During assembly S634, the post apex is welded to a surface of the planarportion of the bone plate such that a longitudinal axis of the post isperpendicular to the surface of the planar portion of the bone plate.The post, which extends from the post apex and protrudes through the midcrest of the alveolar bone, is manufactured according to theabove-described methods in order to accept dental implant abutments.

For the UM-TDI and LM-TDI, a bone plate extending from a buccal end of acylindrical plate of the dental implant may be fabricated. Thecylindrical plate has support lattices extending therefrom, at least onesupport lattice of the support lattices being arranged on a lingual endof the cylindrical plate. The cylindrical plate has an opening in acentral region thereof and the opening may be configured to receive thepost.

Both the bone plate and associated screws provide locking technology toprevent loosening during loading. In addition to the TDI, UM-TDI, orLM-TDI, polyethylene templates, drill guides, and drill stop bushingscan be manufactured via computer-aided design/computer-aided machiningtechniques to guide osteotomies. For example, the above-describedpolyethylene templates, drill guides, and drill stop bushings may becustom manufactured such that the angle, diameter, and depth of anosteotomy is controlled according to the skeletal structure of anindividual patient. In an example, osteotomies are performed via side-and end-cutting surgical burs.

According to an embodiment, selection of the regions of interest duringthe manufacture of the TDI, LM-TDI, or UM-TDI, may be performed by theprocessing circuitry according to a skeletal parameter, for example, aminimal thickness of cortical bone. In another embodiment, selection ofthe regions of the interest during the manufacture of the TDI may beperformed by a surgeon.

With reference to FIG. 7A through FIG. 7C, an exemplary custom printedLM-TDI, for immediate restoration of anatomy and function after toothextraction is illustrated, within the scope of the present disclosure.

In an embodiment, the UM-TDI structure and the LM-TDI structure may besimilar. Therefore, FIG. 7A through FIG. 7C may illustrate that theLM-TDI includes the dental post 701, the cylindrical plate 715, lockingmini screws 703, support lattices 702, and apertures 705 which aresimilar to those described earlier in FIG. 2B through FIG. 2D.

In an embodiment, the dental post 701 in FIG. 7A and FIG. 7B may besimilar to the post 405 of the TDI in FIG. 4A and FIG. 4B.

In FIG. 7A, a perspective view of a dental post 701 secured to LM-TDIcylindrical plate 715 in situ with frictional coupling is shown. In FIG.7B, a side view of the dental post 701 secured to LM-TDI cylindricalplate 715 in situ with frictional coupling is shown.

In an embodiment, the LM-TDI, the support lattices 702 on the LM-YDI mayextend from buccal and lingual ends of the cylindrical plate 715 in FIG.7A. In an example, the thickness of the bone plate of the lower molar(LM) ranges between 1.00 mm and 3.00 mm, and preferably between 1.25 mmand 2.00 mm. The length of the support lattices of the LM-TDI may bedetermined according to locally sufficient cortical bone.

In an embodiment, similar to the UM-TDI, the cylindrical plate 715 ofthe LM-TDI may also have an opening in a central region thereof. Theopening of the cylindrical plate 715 may be configured to receive thedental post 701. The diameter of the cylindrical plate 715 may bebetween 5 mm and 8 mm, and preferably 6 mm. The diameter of the openingof the cylindrical plate 715 may be 3 mm and 6 mm, and preferably 4 mm.

In an embodiment, as briefly described earlier in FIG. 2A, the dentalpost 701 may include a post base 701A, a post body 701B, and a post apex701C which will be described later in FIG. 7A. The dental post 701 maybe configured to receive an abutment. The post body 701B may be the bodyportion of the dental post 701.

In an embodiment, the dental post 701 can be a non-metallic materialsuch as zirconia, ceramic, fiber-reinforced resins, and carbon fiber,fiberglass, or a metallic material such as titanium, stainless steel,titanium alloy, and gold alloy. Other materials, as appropriate, mayalso be used.

In an embodiment, the diameter of the post base 701A of the dental post701 may range between 3 mm and 6 mm. For example, the diameter of thepost base 701A of the dental post 701 may be 4.5 mm. The height of thepost base 701A may be between 2 mm and 3 mm.

In an embodiment, the diameter of the post body 701B of the dental post701 may range between 4 mm and 7 mm. For example, the diameter of thepost body 701B of the dental post 701 may be 5.5 mm. The height of thepost body 701B may be between 6 mm and 10 mm.

In an embodiment, the diameter of the post apex 701C of the dental post701 may range between 3.5 mm and 4 mm. For example, the diameter of thepost apex 701C of the dental post 701 may be 4 mm. The height of thepost apex 701C may be between 2 mm and 3 mm.

In an embodiment, the diameter of the post apex 701C of the dental post701 may be the same as the opening of the cylindrical plate 715. Forexample, the diameter of the post apex 701C of the dental post 701 maybe 4 mm and the opening of the cylindrical plate 715 may be 4 mm.

In an embodiment, locking mini screws 703 may be used to mount theLM-TDI to the buccal and lingual cortices of the patient. The lockingmini screws 703 can be a non-metallic material such as zirconia,ceramic, fiber-reinforced resins, and carbon fiber, fiberglass, or ametallic material such as titanium, stainless steel, titanium alloy, andgold alloy. Other materials, as appropriate, may also be used.

In an embodiment, the number of the locking mini screws 703 may be, butnot limited to, four, as illustrated in FIG. 7A. The length of thelocking mini screws 703 may be between 4 mm and 8 mm. For example, thelength of the locking mini screws 703 may be 5 mm. The diameter of thelocking mini screws 703 may be between 1 mm and 2 mm.

In an embodiment, support lattices 702 may be coupled to the cylindricalplate 715. The support lattices 702 may extend from the buccal andlingual ends the cylindrical plate 715. The support lattices 702 mayinclude apertures 705 for fixation. The support lattices 702 may befixed to the facial skeleton by the locking mini screws 703 insertedinto cortices of the facial skeleton through the apertures 705. In someembodiments, a bone graft alveolus may extend around the dental post701, the cylindrical plate 211, and the support lattices 702.

In an embodiment, the support lattices 702 may have a length between 1mm and 3 mm. The support lattices 702 may have a width between 1 mm and2 mm. The number of the support lattices 702 used in the LM-TDI may bedependent on the number of the locking mini screws 703 and the number ofthe apertures 703. For example, four support lattices 702 are used tosupport four apertures 703, and four locking mini screws 703 are used tofix the dental post 701 through the four apertures 703.

In an embodiment, the support lattices 702 can be a non-metallicmaterial such as zirconia, ceramic, fiber-reinforced resins, and carbonfiber, fiberglass, or a metallic material such as titanium, stainlesssteel, titanium alloy, and gold alloy. Other materials, as appropriate,may also be used.

In some embodiments, the support lattices 702 may not limited to alattice structure. The supporting structures for the apertures can be,but not limited to, a circular structure, a grid structure, or the like.

In an embodiment, the apertures 703 may have a diameter between 1 mm and2 mm. The diameter of the apertures 703 may also dependent on thediameter of the locking mini screws 703. For example, if the diameter ofthe locking mini screws 703 is 1.5 mm, then the diameter of theapertures 703 should be slight larger than 1.5 mm for the insertion ofthe locking mini screws 703 into the apertures 703.

In FIG. 7C, a detailed printed LM-TDI is illustrated. In FIG. 7D, a flowchart of a process of an analog crown over graft is illustrated.

In step S702, an internal alveolar osteotomy is guided by a template.For example, an area 751 in FIG. 7C is the internal alveolar osteotomyarea that is guided by a template generated from a processing circuitry.

In step S704, a LM-TDI is secured to alveolar cortices. For example, theLM-TDI may be secured to the alveolar cortices by the mini lockingscrews 703 as illustrated in FIG. 7C. As mentioned earlier, the diameterof the mini locking screws 703 may be between 1 mm and 2 mm.

In step S706, the dental post 701 is secured to the LM-TDI cylindricalplate 715. For example, as described above, the post apex of the dentalpost 701 may be screwed into the opening of the cylindrical plate 715.

In step S708, bone graft alveolus 753 in FIG. 7C around the LM-TDIcylindrical plate 715 and the dental post 701 is performed.

In step S710, an analog crown 755 in FIG. 7C covers the bone graft. Theanalog crown 755 may be made of, but not limited to, acrylic. The sizeof the analog crown 755 may match the size and shape of the naturalcrown of a tooth being replaced.

In step S712, a gingivae 757 in FIG. 7C is supported by the analog crown755.

In FIG. 8A, the outline of failed conventional dental implants locatedbetween the nerves of the mandible is illustrated on a standard panorexx-ray view. In an embodiment, the panorex x-ray view of the mandibleshows nerves traveling through the mandibular body. The mandibular bodyends at the point the nerves exit the mental foramens. In an embodiment,FIG. 8B and FIG. 8C provide illustrations of a cross sectional view of amandibular body posterior to mental foramina with SL-TDI 804 throughplanes 802. The planes 802 are cross-sectional views within themandibular body posterior to the mental foramens. The failedconventional dental implants are bunched together between the mentalforamens to prevent injury to the nerve. The dental implant of thepresent disclosure may be arranged posterior to the mental foramenswithout injuring the nerves because the dental posts 701 may be arrangedin precisely fabricated slots configured to receive the dental posts701.

With reference to FIG. 9A, an exemplary bilateral SL-TDI 804 forimmediate full arch mandibular reconstruction may be shown within thescope of the present disclosure. FIG. 9B is a cross section view of theexemplary bilateral SL-TDI 804 device.

In FIG. 9A, 906 represents crest of ridge, 908 represents mental nerve,910 represents genial tuberosity. In. FIG. 9B, 912 represents miniscrews engaging inferior border, and 914 represents nerve on buccalaspect of mandible just posterior to mental foramen.

In an embodiment, a complete dental arch reconstruction of a severelyresorbed or deformed mandible uses two bilateral SL-TDI devices 804designed with the plates secured with bone screws 912 into thesublingual cortex on either side of the genial tuberosity 910. EachSL-TDI plate 804 has two dental posts spaced 15 mm apart which areembedded in vertical osteotomies of the lingual cortex, with thepossibility of the posterior dental posts placed in the mandibular bodylingual to the mental nerve 908 since the mental nerve 908 passes nearthe buccal cortex before exiting the mental foreman. Fixation screws 912engage the lingual cortex to secure the SL-TDI devices 804 after finalalignment with an indexed full arch dental prosthesis. Bone graft isplaced in the vertical osteotomy sites around the dental posts andcovered with membrane before closure.

FIG. 10 illustrates a transvestibular implant (TVI) for intra-oral pinfixation of an unstable prosthesis or comminuted LeFort fracture, withinthe scope of the present disclosure.

In an embodiment, for each of the one or more implanted TVI 1002, a boneplate is secured to the facial skeleton via screws inserted into throughapertures of the bone plate. A support rod 1004 is coupled to an end ofthe bone plate and extends through from the facial skeleton to a dentalprosthesis 1000. From the described perspective, the relative dimensionsand position of the bone plate on the facial skeleton, according to anembodiment, are observable. Further, the configuration of the supportrod 1004 is observable, as well as an adjusted support rod 1014, angledin order to follow the contours of the facial skeleton.

In an embodiment, the TVI 1002 is a 1.5 mm to 2 mm diameter titanium pinwith a bone plate feature on one end to attach to cortical bones of thezygoma and nasomaxilla. The titanium pin is bent with a 3-prong plier toconform to the facial bone contours to allow the other pin end to exitthe vestibule to the level of an unstable prosthesis. Sturdy pinfixation is achieved with a pin from the zygoma plate to the prosthesismolar, bilaterally, a pin from the nasomaxilla plate to prosthesiscanine, bilaterally, and a pin as a diagonal brace from zygoma plate toprosthesis canine, bilaterally. The 6 pins, e.g., 1006, are then lutedto the prosthesis or fixated arch bars in the case of fractured maxilla.with adhesives. Essentially this is 4-point intraoral pin fixation totemporarily support an otherwise unstable prosthesis during healing orrecovery from an infection. TVI pins, e.g., 1006, manufactured bytitanium extrusion and stamping, are biased just below the plates toallow the pins, e.g., 1006, to be twisted and separated from the platesupon healing without invasive surgery to remove the entire device. TVI1002 is an essential contingency device of TDI Technology. TVI 1002 maybe useful in traumatology when internal fixation of maxillary fracturesis not possible due to comminuted fractures or gunshot and shrapnelwounds.

With reference to FIG. 11, a lateral sinus wall with a template showingoutline of osteotomy in three views may be shown, within the scope ofthe present disclosure. An osteotomy of the lateral sinus wall withoutcutting the underlying sinus membrane is an essential part of a sinuslift operation to provide particulate bone graft to augment the verticaldimension of the posterior maxillary alveolar ridge. An example of thesinus lift operation procedure is described in Abrahams, et al.,American Journal of Roentgenology. 2000; 174: 1289-1292.10.2214/ajr.174.5.1741289, which is incorporated herein by reference inits entirety for all purposes.

In an embodiment, in FIG. 11, 1102 represents sinus membrane, 1104represents a sinus bony wall, 1106 represents the sinus lift template,and 1108 represents a raised feature on the sinus lift template. Theedge of the sinus lift template 1106 has a beveled feature toaccommodate the burr portion of 1116. The dashed box may represent adifferent view of the lateral sinus wall with a template such as a topview comparing with the other two views. The burr with depth limitbushing gliding against raised feature 1108 on sinus lift template 1106to perform the osteotomy on the sinus bony wall 1104 without cuttingsinus membrane 1102 may be illustrated in FIG. 11. The burr with depthlimit bushing may be made of, but not limited to, titanium or stainlesssteel with the bushing also metal, acrylic or a composite material.

In an embodiment, the sinus membrane 1102 may be a Schneiderianmembrane, which is a mucous membrane that covers the inner part of themaxillary sinus cavity.

In an embodiment, the sinus wall 1104 is bone. The thickness of thesinus wall 1104 bone is variable and may be between 0.5 mm and 2 mm.

In an embodiment, the sinus lift template 1106 may be made of, but notlimited to, 3D printed polymer. The thickness of the master template1106 may be between 1 mm and 3 mm depending on the correspondingunderlying bony sinus wall 1104 thickness, such that the combinedthickness of the sinus lift template 1106 and the sinus wall 1104 is aconstant and equal to the burr 1116 length, which is limited and fixedby the depth-limit bushing 1110. Since the topography and thickness ofthe bony sinus wall 1104 is naturally variable, the CBCT scan willanalyze the bone thickness and send messages to the CPU to 3D print thepolymer master template 1106 in a corresponding manner in order for thethickness of the sinus wall 1104 and the sinus lift template 1106 toremain constant for a fixed length burr to cut through the sinus lifttemplate 1106 overlayed on the bony sinus wall 1104, without cuttingthrough the sinus membrane 1102.

In an embodiment, the raised feature 1108 may be made of, but notlimited to, plastic. The raised feature 1108 is a 3D printed feature ofthe sinus lift template 1106 and it defines the outline of the bonysinus wall 1104 osteotomy. The height of the raised feature 1108 may bebetween 2 mm and 6 mm.

With reference to FIG. 12A through FIG. 12C, a schematic of a verticalosteotomy template 1206 mounted on a master index template 1202 (hereinalso referred to as “master template 1202”) and burr shank 1208 and diskbushing 1209 to insert into the vertical osteotomy template 1206 for TDIvertical osteotomies may be shown, within the scope of the presentdisclosure. To that end, in an embodiment, a channel cutting templateapparatus includes a first guide plate and a second guide platecomprising the vertical osteotomy template 1206 separated by a first gap(or a first channel), the first gap configured to receive the burr shank1208 between the first guide plate and the second guide plate, the burrshank 1208 having a diameter narrower than a width of the first gap. Thechannel cutting template apparatus also includes a first top guide walldisposed on the first guide plate and a second top guide wall disposedon the second guide plate separated by a second gap, the first guidewall and the second guide wall being perpendicular to a plane of thefirst guide plate and the second guide plate, the second gap configuredto receive the disk bushing 1209 (or any type of bushing or stoppingfeature) attached to the burr shank 1208 between the first guide walland the second guide wall, the disk bushing 1209 having a diameternarrower than a width of the second gap, the first guide plate and thesecond guide plate configured to prevent the disk bushing 1209 frompassing beyond a plane of the first guide plate and the second guideplate when the burr shank 1208 is inserted into the first gap and thedisk bushing 1209 is inserted in the second gap. Notably, a thickness ofthe first guide plate and the second guide plate can be based on athickness of the underlying sinus membrane.

In an embodiment, if sinus lift and bone grafting is planned in theposterior vertical osteotomy positions, the 3D printed polymer sinuswall template 1106 is snapped onto the master index template 1202 toperform the sinus wall osteotomy before the TDI vertical osteotomies maybe performed.

In an embodiment, the master template 1106 outlines the osteotomy with araised feature 1108 and controls the depth of the osteotomy by matchingthe thickness and topography of the template guide, e.g., 1106, tocorresponding CT data of the underlying bone thickness and topography.The depth of the osteotomy may be between 0.5 mm and 3 mm.

In an embodiment, the uniform combined thickness of template guide,e.g., 1106, and bone allows a bone burr with a depth-limit bushing,e.g., 1110, to glide against the raised feature 1108 to create theosteotomy at the proper depth to prevent cutting the sinus mucosalining. The proper depth may be between 1 mm and 3 mm.

In an embodiment, completion of TDI vertical osteotomies includes thecompleting the sinus wall osteotomy, removing the sinus wall template1106, reflecting the sinus membrane 1102, and snapping the verticalosteotomy template 1206 onto the master index template 1202.

In an embodiment, the template 1106 may be closely adapted to the sinuswall 1104 as illustrated in the dashed box 1112. The template thicknessmay vary to corresponding CT data of sinus wall template 1106 to createa uniform combined thickness. The thickness of the template 1106 may bebetween 1 mm and 3 mm. The uniform combined thickness may be between 1.5mm and 4 mm. A burr with depth limiter accurately cuts sinus wall 1104to sinus membrane 1102 with a fixed length burr. The fixed length burrmay have a length of approximately 3 mm.

In an embodiment, a resection template 1201 is placed after flaps arereflected and teeth removed. The resection template 1201 is a 3D printedpolymer to straddle the maxillary alveolar bone 1204 at the level of theplanned alveolectomy. The resection template 1201 is indexed to thenasopalatine foramina, or the nasal crest, and posterior alveolarcrestal landmarks, bilaterally, and secured with bone screws to themaxillary arch with three projecting index tabs around the arch. Theresection template 1201 guides the planned horizontal alveolectomy witha flat cutting shelf to serve as a platform for subsequent templates andas a retractor to reflect and protect soft tissue flaps.

After, the horizontal osteotomy master index template 1202 replacesresection template 1201 using same index holes used to align theresection template 1201.

In some embodiments, a 3D printed polymer vertical osteotomy template1206 is snapped onto features of the master index template 1202. Thevertical osteotomy template 1206 may have horizontal channels to guideburrs 1210 (e.g., shannon type) fitted with the disk bushings 1209 whichslide into the horizontal channels to support accurate verticalosteotomies 1212 through the alveolar bone 1204. The vertical osteotomytemplate 1206 may be made of, but not limited to, polymer, plastic, orthe like. The height of the vertical osteotomy template 1206 may bebetween 3 mm and 5 mm.

In an embodiment, the horizontal channels of the vertical osteotomytemplate 1206 and bushings, e.g., 1208 and 1209, may be made unique interms of diameter and thickness to avoid wrong burrs from being used inthe four different buccal osteotomy positions around the arch. The widthof the horizontal channels of the vertical osteotomy template 1206 maybe between 3 mm and 5 mm and the diameter of the bushings 1209 may bebetween 8 mm and 12 mm. The thickness of the channels may be between 2mm and 4 mm and the thickness of the bushings 1209 may be between 2 mmand 4 mm.

In an embodiment, the TDI alignment/visual objective template 1203, withembedded metal copings on the undersurface to receive the TDI deviceswith the abutments screwed to dental posts, is manipulated back onto themaster index template 1202 and seated as the abutments of each TDIdevice are secured to the copings with prosthetic screws. The TDIdevices, now secured to a TDI alignment/visual objective template 1203and positioned against the facial bone, are secured to the facial bonewith locking screws. Locking screw technology may prevent bone screwsfrom loosening from TDI devices and prevent tension between the TDIplates and bone from occurring when the screws are seated.

In an embodiment, the TDI alignment/visual objective template 1203 isunscrewed from TDI abutments and removed from master index template1202. The master index template 1202 is unscrewed and removed frommaxillary alveolar bone 1204. The wounds are irrigated. The verticalosteotomy sites are bone grafted around the embedded dental posts. Themembranes are placed over grafts. The flaps are closed around protrudingabutments attached to TDI dental posts. The temporary prosthesis 1207,with a properly contoured undersurface and accurately embedded copingsto match those of the TDI alignment/visual objective template 1203, isplaced over the abutments and secured with prosthetic screws.

FIG. 12D-1 to FIG. 12M-1 show a sequence of stents used to preciselyexcise the alveolar bone 1204 using a resection template 1201 fixated atthe corresponding horizontal level based on anatomic landmarks and using3 screws engaging the resection template 1201 around the arch, withinthe scope of the present disclosure.

In particular, FIG. 12E-1 shows the dentition and appropriate alveolarbone excised. FIG. 12F-1 shows replacement of the resection template1201 with the master index template 1202 fixated with 3 screws intoindex tabs of the master index template 1202 into screw holes used tofixate the resection template 1201. FIG. 12G-1 shows the TDIalignment/visual objective template 1203 snapped onto the master indextemplate 1202 using 3 fasteners as shown in FIG. 12N-1. Once the TDIalignment/visual objective template 1203 position confirms the correctvisual objective, the TDI alignment/visual objective template 1203 issnapped off of the master index template 1202. FIG. 12H-1 shows thealveolar bone 1204, the master index template 1202, and the verticalosteotomy template 1206. Notably, the burr can be introduced into thevertical slot osteotomy with the drilling. In FIG. 12I-1, the verticalosteotomy template 1206 is removed and the master index template andslots drilled into the skeleton remain. In FIG. 12J-1, the TDIalignment/visual objective template 1203 including copings 1203 a isintroduced.

Before the TDI alignment/visual objective template 1203 is snappedcompletely into the master index template 1202, the TDI devices can beplaced into the vertical osteotomy sites and against the facial bone asshown in FIG. 12K-1. Manipulation of the TDI devices to couple withmetal copings 1203A is then performed until abutment screws fixate theTDI alignment/visual objective template 1203 to the TDI devices, withthe devices fully seated into the osteotomy sites and aligned to thefacial skeleton. Locking bone screws then fixate the TDI devices to thefacial bones.

In FIG. 12K-1, the TDI devices are attached to the TDI alignment/visualobjective template 1203 and positioned into the slots. Notably, theplate should be positioned to the facial bone and the screws can go inat the same time, thus placing everything on and locking to the bonesimultaneously.

FIG. 12L-1 shows removal of the master index template 1202 and the TDIalignment/visual objective template 1203. In this step, the wounds areirrigated, bone graft is placed in the vertical osteotomy sites,membranes placed, and the mucosa closed around the protruding TDI dentalposts.

In FIG. 12M-1, the temporary prosthesis 1207 is coupled to the TDIdevices using embedded metal copings in a similar manner done to couplethe TDI alignment/visual objective template 1203 in the previous steps.

FIG. 12N-1 and FIG. 12N-2 show views of the fasteners used tointerchange the templates, within the scope of the present disclosure.These can provide a snap-on feature with ease of removal (i.e., snapoff).

FIG. 12N-1 shows the vertical osteotomy template 1206 snapped onto themaster index template 1202 using identical fasteners. The burr with diskbushing (1208,1209,1210) are then introduced into the horizontal guidesof the vertical osteotomy template 1206 to cut the vertical osteotomies1212 in 4 areas around the arch as shown in FIG. 12I-1.

FIG. 12D-2 to FIG. 12M-2 is the occlusal view of the same templates andsequence of steps, within the scope of the present disclosure. FIG.12D-2 to 12M-2 generally show the same sequence of steps as justdescribed.

A similar approach is used on the mandibular arch, with the exceptionthe vertical osteotomies are made in the lingual cortex, as shown inFIG. 8.

In an embodiment, a success to the present disclosure, e.g., TDITechnology, is an accurate surgery and a precise placement of the custom3D printed TDI devices, abutments, and temporary prostheses. Custom 3Dprinted polymer templates support the surgeon to execute all bonecutting procedures, and the alignment of devices and prostheses.

In an embodiment, the process begins with virtual surgical planning(VSP) to design the final prosthetic objective with computer images of3D CT scans, photos, and models, all merged to show the preoperativecondition and the postoperative objective. The TDI devices are designed,3D printed, and platforms milled to receive abutments. A 2 mm band ofthe dental post just below the platform is finished with a smoothsurface to reduce oral bacteria contamination if the dental post isexposed due to crestal bone resorption. The rest of the embedded TDIdevice retains a rough surface to enhance osseointegration. Abutmentsare selected to connect the TDI devices to the temporary prosthesis. Thetemporary prosthesis is designed and either 3D printed or milled from ablock of dental acrylic. Index templates are then designed, and 3Dprinted or molded to dental models with snap on cutting and alignmentguides.

FIG. 13 is a flow diagram of a preoperative procedure within the scopeof the present disclosure.

In an embodiment, once the patient is cleared for the TDI surgicalprocedure in the step S1302, the restorative dentist performs the usualprosthetic work up with models, photos and x-rays in the step S1304. Therestorative dentist fabricates a radiographic (XR) stent to fit over theexisting teeth (or edentulous arch) and palate of maxilla with embeddedmetal markers to radiographically tag three areas around the palatalaspect of the arch in the step S1306. The XR stent may be fitted to thepatient during the preoperative CT scan in the step S1308. The temporaryprosthesis is then waxed up and duplicated in acrylic with radiographicbarium sulfate acrylic paint to accurately outline the desired dentalanatomy. This XR prosthesis uses XR stent with embedded metal markers asthe baseplate. This XR prosthesis is then CT scanned as a separatestructure in the step S1310.

In an embodiment, the CT scan images are then analyzed on an onlineshared workplace by the XYZ computer technician, surgeon and restorativedentist in the step S1312. The preoperative CT scan with XR stent allowsthe team to perform virtual surgery, import the XR prosthesis image andsuper-impose this XR prosthesis as the postoperative objective, withmetal markers aligned and prosthesis correctly oriented to theunderlying facial bones in the step S1314. In a manner similar todigitally planned orthognathic surgery, the XR prosthesis can be moveddigitally to correct anterior-posterior, vertical, or midlinediscrepancies seen on overlaid CT images and photos.

In an embodiment, the team satisfied with the XR prosthesis position onthe computer image, then digitally adds TDI dental post images intoideal position and builds the supporting TDI plates, using integrateddesign controls, and adds bone screw images into the facial bones tocomplete the virtual TDI devices. The technician then designs the masterTDI index template, vertical osteotomy template and TDI alignment/visualobjective template based on the XR prosthesis to support the surgeon inthe execution of the procedures. Once digitally finalized, thetechnician exports the data to XYZ for manufacturing in the step S1316.

In an embodiment, data is also sent to a dental lab along with the waxedprosthesis (contoured to anticipate soft tissues around TDI implantplatforms) for optical scanning to mill and finish the temporaryprosthesis out of dental acrylic in the step S1318. The temporaryprosthesis may have embedded titanium copings to match the plannedabutment platforms in the step S1320.

In an embodiment, a similar prosthetic procedure is done for themandible using the lingual bone plate as the stable area to orient theTDI dental posts and attached plates.

In an embodiment, all of these TDI preoperative procedures support theconcept of a prosthetically-driven treatment plan: Prostheses aredesigned, radiographically tagged, oriented to the preoperative facialskeleton on a 3D CT scan, and then the TDI devices are designed tosupport the prosthesis in the step S1322. Templates support the surgeonto perform the surgical procedures within each dental arch and align theTDI's to the facial bones to eliminate the need to perform tedious,time-consuming free-hand surgical and prosthetic procedures, or pick-uptransfers currently done with All-on-Four procedures in the step S1324.

In an embodiment, execution of the TDI reconstruction as described abovewill be precise and predictable. This is in contrast to current dentalimplant reconstruction using the All-on-Four approach which requires upto 4 hours per dental arch of chairside craftsmanship with unpredictableresults which not only fatigues the patient but the treatment team inthe step S1326.

In an embodiment, next, a hardware description of the data processingdevice according to exemplary embodiments is described with reference toFIG. 14. In FIG. 14, the data processing device includes a CPU 1470which performs the processes described above and below. The process dataand instructions may be stored in memory 1472. These processes andinstructions may also be stored on a storage medium disk 1474 such as ahard drive (HDD) or portable storage medium or may be stored remotely.Further, the claimed advancements are not limited by the form of thecomputer-readable media on which the instructions of the inventiveprocess are stored. For example, the instructions may be stored on CDs,DVDs, in FLASH memory, RAM, ROM, PROM, EPROM, EEPROM, hard disk or anyother information processing device with which the data processingdevice communicates, such as a server or computer.

In an embodiment, further, the claimed advancements may be provided as autility application, background daemon, or component of an operatingsystem, or combination thereof, executing in conjunction with CPU 1470and an operating system such as Microsoft Windows 7, UNIX, Solaris,LINUX, Apple MAC-OS and other systems known to those skilled in the art.

In an embodiment, the hardware elements in order to achieve the dataprocessing device may be realized by various circuitry elements, knownto those skilled in the art. For example, CPU 1470 may be a Xenon orCore processor from Intel of America or an Opteron processor from AMD ofAmerica, or may be other processor types that would be recognized by oneof ordinary skill in the art. Alternatively, the CPU 1470 may beimplemented on an FPGA, ASIC, PLD or using discrete logic circuits, asone of ordinary skill in the art would recognize. Further, CPU 1470 maybe implemented as multiple processors cooperatively working in parallelto perform the instructions of the inventive processes described above.

In an embodiment, the data processing device in FIG. 14 also includes anetwork controller 1476, such as an Intel Ethernet PRO network interfacecard from Intel Corporation of America, for interfacing with network1400. As can be appreciated, the network 1400 can be a public network,such as the Internet, or a private network such as an LAN or WANnetwork, or any combination thereof and can also include PSTN or ISDNsub-networks. The network 1400 can also be wired, such as an Ethernetnetwork, or can be wireless such as a cellular network including EDGE,3G and 4G wireless cellular systems. The wireless network can also beWiFi, Bluetooth, or any other wireless form of communication that isknown.

In an embodiment, the data processing device further includes a displaycontroller 1478, such as a NVIDIA GeForce GTX or Quadro graphics adaptorfrom NVIDIA Corporation of America for interfacing with display 1480,such as a Hewlett Packard HPL2445w LCD monitor. A general purpose I/Ointerface 1482 interfaces with a keyboard and/or mouse 1484 as well as atouch screen panel 1486 on or separate from display 1480. Generalpurpose I/O interface 1482 also connects to a variety of peripherals1488 including printers and scanners, such as an OfficeJet or DeskJetfrom Hewlett Packard.

In an embodiment, a sound controller 1490 is also provided in the dataprocessing device, such as Sound Blaster X-Fi Titanium from Creative, tointerface with speakers 1492 or microphone thereby providing soundsand/or music.

In an embodiment, the general purpose storage controller 1494 connectsthe storage medium disk 1474 with communication bus 1496, which may bean ISA, EISA, VESA, PCI, or similar, for interconnecting all of thecomponents of the data processing device. A description of the generalfeatures and functionality of the display 1480, keyboard and/or mouse1484, as well as the display controller 1478, storage controller 1494,network controller 1476, sound controller 1490, and general purpose I/Ointerface 1482 is omitted herein for brevity as these features areknown.

In an embodiment, this invention is for patients with tooth spaces ofless than 6 mm mesial-distal. This condition is commonly found inmaxillary lateral incisor and mandibular incisor positions. Conventionaldental implants have as their narrowest implant 2.9 mm diameter roundposts. It is generally accepted the minimal distance between the side ofan implant and adjacent tooth is 1.75 mm, and this requires a 6.4 mmdentoalveolar space between the roots at the alveolar crest toaccommodate a 2.9 mm implant. Convergent adjacent roots are anotherlimiting condition for conventional dental implants.

The present disclosure solves the conventional dental implant limitationwith the narrow device, e.g., N-TDI. The N-TDI has a 3D printed titaniumdental post with an oval cross-section of less than 2 mm mesial-distaland 3 mm or more buccal-lingual dimension for strength. Since the N-TDIdental post is not screwed into the alveolus, instead, the N-TDI dentalpost may be placed in a vertical osteotomy. In addition, the N-TDI'sattached plate and screws secure the N-TDI device for stability.

Rescue Transalveolar Dental Implant.

In some embodiments, the present invention, e.g., TDI Technologies, isthe rescue dental implant device, e.g., R-TDI, which may replace failedconventional dental implants supporting an expensive full archprosthesis. Essentially, after the prosthesis is unscrewed, failedconventional implants removed, alveolus debrided, custom 3D printedtitanium R-TDIs are attached to the dental prosthesis as a retrofit andsecured to adjacent cortical bones with the attached plate after theprosthesis is screwed to the remaining conventional implants. Thealveolar defects are then bone grafted around the one-piece embeddedR-TDI devices.

Obviously, numerous modifications and variations are possible in lightof the above teachings. It is therefore to be understood that within thescope of the appended claims, the invention may be practiced otherwisethan as specifically described herein.

Embodiments of the present disclosure may also be as set forth in thefollowing parentheticals.

(1) A method of manufacture of a dental implant for a molar, comprisingacquiring, by processing circuitry, structural data corresponding to oneor more bones of the facial skeleton, the one or more bones of thefacial skeleton being proximate the molar, selecting, by the processingcircuitry and as a dental implant fixation surface, a surface of the oneor more bones of the facial skeleton based upon a determined thicknessof the one or more bones of the facial skeleton, generating, by theprocessing circuitry and based on the selected dental implant fixationsurface, a contoured surface of the dental implant, and fabricating,based upon an instruction transmitted by the processing circuitry, abone plate extending from a buccal end of a cylindrical plate of thedental implant, the cylindrical plate having support lattices extendingtherefrom, at least one support lattice of the support lattices beingarranged on a lingual end of the cylindrical plate, the cylindricalplate having an opening in a central region thereof, the opening beingconfigured to receive a dental post.

(2) The method of manufacture according to (1), wherein the bone plateis fabricated via direct metal laser sintering.

(3) The method of manufacture according to either (1) or (2), whereinthe structural data includes the determined thickness of the one or morebones of the facial skeletons.

(4) The method of manufacture according to any one of (1) to (3),wherein the molar includes upper molar and lower molar.

(5) The method of manufacture according to any one of (1) to (4),wherein the instruction is generated by the processing circuitry basedupon the selection of the dental implant fixation surface and thegeneration of the contoured surface.

(6) The method of manufacture according to any one of (1) to (5),wherein the dental post is connected to the molar.

(7) The method of manufacture according to any one of (1) to (6),wherein the support lattices includes an aperture for fixation.

(8) The method of manufacture according to any one of (1) to (7),wherein the support lattices are fixed to the facial skeleton by a screwinserted into alveolar cortices of the facial skeleton through theaperture.

(9) The method of manufacture according to any one of (1) to (8),wherein the dental implant is titanium.

(10) The method of manufacture according to any one of (1) to (9),wherein the dental post is frictionally-coupled to the opening of thecylindrical plate.

(11) A dental implant for a molar, comprising a dental post, acylindrical plate having an opening in a central region thereof, theopening being configured to receive the dental post, a bone plateextending from a buccal end of the cylindrical plate, the bone platehaving a surface for contact with one or more bones of the facialskeleton, the surface being contoured relative to a surface of the oneor more bones of the facial skeleton and based on a thickness of the oneor more bones of the facial skeleton, and support lattices coupled tothe cylindrical plate, the support lattices extending from a lingual endthe cylindrical plate, the support lattices including an aperture forfixation.

(12) The dental implant of (11), wherein the dental post isfrictionally-coupled to the opening of the cylindrical plate.

(13) The dental implant of either (11) or (12), wherein the dentalimplant is titanium.

(14) The dental implant of any one of (11) to (13), wherein the supportlattices are fixed to the facial skeleton by a screw inserted intoalveolar cortices of the facial skeleton through the aperture.

(15) The dental implant of any one of (11) to (14), wherein a bone graftalveolus extends around the dental post, the cylindrical plate, and thesupport lattices.

(16) The dental implant of any one of (11) to (15), wherein the boneplate is fabricated via direct metal laser sintering.

(17) The dental implant of any one of (11) to (16), wherein the molarincludes upper molar and lower molar.

(18) The dental implant of any one of (11) to (17), wherein a structuredata corresponding to one or more bones of the facial skeleton includingthe thickness of the one or more bones of the facial skeleton isacquired by a processing circuitry.

(19) The dental implant of any one of (11) to (18), wherein theprocessing circuitry further provides an instruction to fabricate thebone plate.

(20) A transalveolar dental implant (TDI) alignment/visual analogtemplate apparatus, comprising: embedded copings to receive and alignTDI devices into vertical osteotomies formed by a channel/cuttingtemplate apparatus, the TDI aligned by the TDI alignment/visual analogtemplate apparatus being stabilized to facial skeleton, a prefabricatedtemporary prosthesis with the embedded copings located as in the TDIalignment/visual analog template being coupled to the TDI deviceswithout any further adjustments or chairside customization.

(21) A channel cutting template apparatus, comprising: a first guideplate and a second guide plate separated by a first gap, the first gapconfigured to receive a burr shank between the first guide plate and thesecond guide plate, the burr shank having a diameter narrower than awidth of the first gap; and a first top guide wall disposed on the firstguide plate and a second top guide wall disposed on the second guideplate separated by a second gap, the first guide wall and the secondguide wall being perpendicular to a plane of the first guide plate andthe second guide plate, the second gap configured to receive a bushingattached to the burr shank between the first guide wall and the secondguide wall, the bushing having a diameter narrower than a width of thesecond gap, the first guide plate and the second guide plate configuredto prevent the bushing from passing beyond a plane of the first guideplate and the second guide plate when the burr shank is inserted intothe first gap and the bushing is inserted in the second gap.

By providing the features of the disclosure, it is possible to printthermoplastic layers or films using the optical mold which is controlledby the temperature control unit. This is different with the priorsystems since the temperature of the prior systems cannot be controlledso the quality of thermoplastic layers or films is lower.

The foregoing discussion discloses and describes merely exemplaryembodiments of the present invention. As will be understood by thoseskilled in the art, the present invention may be embodied in otherspecific forms without departing from the spirit or essentialcharacteristics thereof. Accordingly, the disclosure of the presentinvention is intended to be illustrative, but not limiting of the scopeof the invention, as well as other claims. The disclosure, including anyreadily discernible variants of the teachings herein, defines, in part,the scope of the foregoing claim terminology such that no inventivesubject matter is dedicated to the public.

1. A method of manufacture of a dental implant for a molar, comprising:acquiring, by processing circuitry, structural data corresponding to oneor more bones of the facial skeleton, the one or more bones of thefacial skeleton being proximate the molar; selecting, by the processingcircuitry and as a dental implant fixation surface, a surface of the oneor more bones of the facial skeleton based upon a determined thicknessof the one or more bones of the facial skeleton; generating, by theprocessing circuitry and based on the selected dental implant fixationsurface, a contoured surface of the dental implant; and fabricating,based upon an instruction transmitted by the processing circuitry, abone plate extending from a buccal end of a cylindrical plate of thedental implant, the cylindrical plate having support lattices extendingtherefrom, at least one support lattice of the support lattices beingarranged on a lingual end of the cylindrical plate, the cylindricalplate having an opening in a central region thereof, the opening beingconfigured to receive a dental post.
 2. The method of manufactureaccording to claim 1, wherein the bone plate is fabricated via directmetal laser sintering.
 3. The method of manufacture according to claim1, wherein the structural data includes the determined thickness of theone or more bones of the facial skeletons.
 4. The method of manufactureaccording to claim 1, wherein the molar includes upper molar and lowermolar.
 5. The method of manufacture according to claim 1, wherein theinstruction is generated by the processing circuitry based upon theselection of the dental implant fixation surface and the generation ofthe contoured surface.
 6. The method of manufacture according to claim1, wherein the dental post is connected to the molar.
 7. The method ofmanufacture according to claim 1, wherein the support lattices includesan aperture for fixation.
 8. The method of manufacture according toclaim 7, wherein the support lattices are fixed to the facial skeletonby a screw inserted into alveolar cortices of the facial skeletonthrough the aperture.
 9. The method of manufacture according to claim 1,wherein the dental implant is titanium.
 10. The method of manufactureaccording to claim 1, wherein the dental post is frictionally-coupled tothe opening of the cylindrical plate.
 11. A dental implant for a molar,comprising: a dental post; a cylindrical plate having an opening in acentral region thereof, the opening being configured to receive thedental post; a bone plate extending from a buccal end of the cylindricalplate, the bone plate having a surface for contact with one or morebones of the facial skeleton, the surface being contoured relative to asurface of the one or more bones of the facial skeleton and based on athickness of the one or more bones of the facial skeleton; and supportlattices coupled to the cylindrical plate, the support latticesextending from a lingual end the cylindrical plate, the support latticesincluding an aperture for fixation.
 12. The dental implant of claim 11,wherein the dental post is frictionally-coupled to the opening of thecylindrical plate.
 13. The dental implant of claim 11, wherein thedental implant is titanium.
 14. The dental implant of claim 11, whereinthe support lattices are fixed to the facial skeleton by a screwinserted into alveolar cortices of the facial skeleton through theaperture.
 15. The dental implant of claim 11, wherein a bone graftalveolus extends around the dental post, the cylindrical plate, and thesupport lattices.
 16. The dental implant of claim 11, wherein the boneplate is fabricated via direct metal laser sintering.
 17. The dentalimplant of claim 11, wherein the molar includes upper molar and lowermolar.
 18. The dental implant of claim 11, wherein a structure datacorresponding to one or more bones of the facial skeleton including thethickness of the one or more bones of the facial skeleton is acquired bya processing circuitry.
 19. The dental implant of claim 18, wherein theprocessing circuitry further provides an instruction to fabricate thebone plate.
 20. A transalveolar dental implant (TDI) alignment/visualanalog template apparatus, comprising: embedded copings to receive andalign TDI devices into vertical osteotomies formed by a channel/cuttingtemplate apparatus, the TDI aligned by the TDI alignment/visual analogtemplate apparatus being stabilized to facial skeleton, a prefabricatedtemporary prosthesis with the embedded copings located as in the TDIalignment/visual analog template being coupled to the TDI deviceswithout any further adjustments or chairside customization.